Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials

Maura D Iversen,1– 3 Marie Andre,2 Johan von Heideken2 1College of Health Professions, Sacred Heart University, Fairfield, CT, USA; 2Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; 3Section of Clinical Sciences, Division of Immunology, Rheumatology & Immuni...

Full description

Bibliographic Details
Main Authors: Iversen MD, Andre M, von Heideken J
Format: Article
Language:English
Published: Dove Medical Press 2022-04-01
Series:Pediatric Health, Medicine and Therapeutics
Subjects:
Online Access:https://www.dovepress.com/physical-activity-interventions-in-children-with-juvenile-idiopathic-a-peer-reviewed-fulltext-article-PHMT
_version_ 1818007404228378624
author Iversen MD
Andre M
von Heideken J
author_facet Iversen MD
Andre M
von Heideken J
author_sort Iversen MD
collection DOAJ
description Maura D Iversen,1– 3 Marie Andre,2 Johan von Heideken2 1College of Health Professions, Sacred Heart University, Fairfield, CT, USA; 2Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; 3Section of Clinical Sciences, Division of Immunology, Rheumatology & Immunity, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USACorrespondence: Maura D Iversen, College of Health Professions, Sacred Heart University, 5151 Park Avenue, Fairfield, CT, 06825, USA, Tel +1 203 396-8024, Fax +1 203-396-8025, Email iversenm@sacredheart.eduIntroduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.Materials and Methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and outcomes were extracted. Study internal validity and intervention attributes were assessed.Results: A total of 555 studies were identified, with 13 studies from 10 countries included. Data from 672 children diagnosed with juvenile idiopathic arthritis (JIA) (range of mean ages, 8.7 to 16.1 years) were analyzed. Fifty-two percent of intervention arms incorporated strengthening exercise alone or combined with other exercise, with 61.9% performed 3x/week. About 43.5% of sessions lasted > 45 to ≤ 60 minutes and 65.2% of programs were ≥ 12 to < 28 weeks. PA interventions improved function and symptoms without adverse events. Intervention details were missing especially regarding PA intensity, reasons for dropouts, and adherence. Only two studies incorporated strategies to promote adherence.Discussion: RCTs of PA interventions in JA only include JIA. Available RCTs used mixed modes of interventions. Reporting of PA interventions lacks sufficient detail to discern the dose-response relationship. Strategies to motivate engagement in PA and to support families to promote PA are lacking, as are studies of long-term outcomes.Conclusion: There are limited RCTs of PA interventions in JIA. Adherence was better with low intensity programs. PA interventions for JIA yield positive health benefits but better reporting of PA intervention details is needed to generate more high-quality evidence and inform clinical practice.Prospero Registration: Maura Iversen, Johan von Heideken, Marie Andre. Physical Activity in Children with Rheumatic Diseases: a systematic review. PROSPERO 2021 CRD42021274634 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274634.Keywords: physical activity, juvenile idiopathic arthritis, exercise
first_indexed 2024-04-14T05:15:12Z
format Article
id doaj.art-0e76c63f915047ccbc887d75a79fd872
institution Directory Open Access Journal
issn 1179-9927
language English
last_indexed 2024-04-14T05:15:12Z
publishDate 2022-04-01
publisher Dove Medical Press
record_format Article
series Pediatric Health, Medicine and Therapeutics
spelling doaj.art-0e76c63f915047ccbc887d75a79fd8722022-12-22T02:10:23ZengDove Medical PressPediatric Health, Medicine and Therapeutics1179-99272022-04-01Volume 1311514374500Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled TrialsIversen MDAndre Mvon Heideken JMaura D Iversen,1– 3 Marie Andre,2 Johan von Heideken2 1College of Health Professions, Sacred Heart University, Fairfield, CT, USA; 2Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; 3Section of Clinical Sciences, Division of Immunology, Rheumatology & Immunity, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USACorrespondence: Maura D Iversen, College of Health Professions, Sacred Heart University, 5151 Park Avenue, Fairfield, CT, 06825, USA, Tel +1 203 396-8024, Fax +1 203-396-8025, Email iversenm@sacredheart.eduIntroduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.Materials and Methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and outcomes were extracted. Study internal validity and intervention attributes were assessed.Results: A total of 555 studies were identified, with 13 studies from 10 countries included. Data from 672 children diagnosed with juvenile idiopathic arthritis (JIA) (range of mean ages, 8.7 to 16.1 years) were analyzed. Fifty-two percent of intervention arms incorporated strengthening exercise alone or combined with other exercise, with 61.9% performed 3x/week. About 43.5% of sessions lasted > 45 to ≤ 60 minutes and 65.2% of programs were ≥ 12 to < 28 weeks. PA interventions improved function and symptoms without adverse events. Intervention details were missing especially regarding PA intensity, reasons for dropouts, and adherence. Only two studies incorporated strategies to promote adherence.Discussion: RCTs of PA interventions in JA only include JIA. Available RCTs used mixed modes of interventions. Reporting of PA interventions lacks sufficient detail to discern the dose-response relationship. Strategies to motivate engagement in PA and to support families to promote PA are lacking, as are studies of long-term outcomes.Conclusion: There are limited RCTs of PA interventions in JIA. Adherence was better with low intensity programs. PA interventions for JIA yield positive health benefits but better reporting of PA intervention details is needed to generate more high-quality evidence and inform clinical practice.Prospero Registration: Maura Iversen, Johan von Heideken, Marie Andre. Physical Activity in Children with Rheumatic Diseases: a systematic review. PROSPERO 2021 CRD42021274634 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274634.Keywords: physical activity, juvenile idiopathic arthritis, exercisehttps://www.dovepress.com/physical-activity-interventions-in-children-with-juvenile-idiopathic-a-peer-reviewed-fulltext-article-PHMTphysical activityjuvenile idiopathic arthritisexercise
spellingShingle Iversen MD
Andre M
von Heideken J
Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials
Pediatric Health, Medicine and Therapeutics
physical activity
juvenile idiopathic arthritis
exercise
title Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials
title_full Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials
title_fullStr Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials
title_full_unstemmed Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials
title_short Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials
title_sort physical activity interventions in children with juvenile idiopathic arthritis a systematic review of randomized controlled trials
topic physical activity
juvenile idiopathic arthritis
exercise
url https://www.dovepress.com/physical-activity-interventions-in-children-with-juvenile-idiopathic-a-peer-reviewed-fulltext-article-PHMT
work_keys_str_mv AT iversenmd physicalactivityinterventionsinchildrenwithjuvenileidiopathicarthritisasystematicreviewofrandomizedcontrolledtrials
AT andrem physicalactivityinterventionsinchildrenwithjuvenileidiopathicarthritisasystematicreviewofrandomizedcontrolledtrials
AT vonheidekenj physicalactivityinterventionsinchildrenwithjuvenileidiopathicarthritisasystematicreviewofrandomizedcontrolledtrials